External control of the public water supply in 29 Brazilian cities

Moimaz, Suzely Adas Saliba; Saliba, Orlando; Chiba, Fernando Yamamoto; Saliba, Nemre Adas

doi:10.1590/s1806-83242012000100003

Cited by 14 publications

(19 citation statements)

References 21 publications

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“…In Cachoeiras do Sul, RS, in Piracicaba, SP, and in a study of 29 Brazilian cities 63.4% 20 , 85% 21 and 53.5% 22 of the samples, respectively, were within acceptable levels. In contrast, in Ponta Grossa, PR, two-thirds of the samples were outside the ideal level; 23 in the state of Piauí, only 4.3% of samples were within the optimal range, 24 and 53.6% of the samples from the island of São Luis, MA, were less than the optimal range, 25 compromising the benefits of the fluoridation process.…”

Section: Discussionmentioning

confidence: 78%

Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis

et al. 2015

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Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis Abstract: Current Brazilian law regarding water fluoridation classification is dichotomous with respect to the risks of and benefits for oral diseases, and fluoride (F) concentrations less than 0.6 or above 0.8 mg F/L are considered outside the normal limits. Thus, the law does not consider that both caries and fluorosis are dependent on the dosage and duration of fluoride exposure because they are both chronic diseases. Therefore, this study evaluated the quality of water fluoridation in Maringá, PR, Brazil, considering a new classification for the concentration of F in water the supply, based on the anticaries benefit and risk of fluorosis (CECOL/USP, 2011). Water samples (n = 325) were collected monthly over one year from 28 distribution water networks: 20 from treatment plants and 8 from artesian wells. F concentrations were determined using a specific ion electrode. The average F concentration was 0.77 mg F/L (ppm F), ranging from 0.44 to 1.22 mg F/L. Considering all of the water samples analyzed, 83.7% of them presented from 0.55 to 0.84 mg F/L, and according to the new classification used, they would provide maximum anticaries benefit with a low risk of fluorosis. This percentage was lower (75.4%) in the water samples supplied from artesian wells than from those distributed by the treatment plant (86%). In conclusion, based on the new classification of water F concentrations, the quality of water fluoridation in Maringá is adequate and is within the range of the best balance between risk and benefit.

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Section: Discussionmentioning

confidence: 78%

Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis

et al. 2015

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“…Water fluoridation is an effective and safe means of preventing dental caries; therefore, monitoring of the quality of the public water supply and its fluoride levels is necessary and should be a priority in health vigilance activities. 25,26,27 The results of this study will assist municipal health services by demonstrating that a 1.2 ppm fluoride concentration does not greatly affect the population and, therefore, there is no need for costly investments in the adequacy of the water supply system.…”

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confidence: 82%

Dental fluorosis and its influence on children’s life

et al. 2015

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This study verified the prevalence of dental fluorosis in 12-year-old children and its association with different fluoride levels in the public water supply, and evaluated the level of perception of dental fluorosis by the studied children. To assess fluorosis prevalence, clinical examinations were performed and a structured instrument was used to evaluate the self-perception of fluorosis. The water supply source in the children's area of residence since birth was used as the study criterion. In total, 496 children were included in the study. Fluorosis was diagnosed in 292 (58.9%) children; from these, 220 (44.4%) children were diagnosed with very mild fluorosis, 59 (11.9%) with mild fluorosis, 12 (2.4%) with moderate fluorosis, and 1 (0.2%) child with severe fluorosis. A significant association (p = 0.0004) was observed between the presence of fluorosis and areas with excessive fluoride in the water supply. Among the 292 children that showed fluorosis, 40% perceived the presence of spots in their teeth. The prevalence of fluorosis was slightly high, and the mildest levels were the most frequently observed. Although most of the children showed fluorosis to various degrees, the majority did not perceive these spots, suggesting that this alteration did not affect their quality of life.

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“…Another 36-month study found that approximately 43% of the samples from cities with only a single source of water were outside of the recommended parameters 24 . Deficiencies in fluoridation were also described in studies performed in other regions 3,15 .…”

Section: Discussionmentioning

confidence: 77%

Water fluoridation in 40 Brazilian cities: 7 year analysis

Moimaz

Saliba

et al. 2013

J. Appl. Oral Sci.

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Objectives:Fluoride levels in the public water supplies of 40 Brazilian cities were analyzed and classified on the basis of risk/benefit balance.Material and Methods:Samples were collected monthly over a seven-year period from three sites for each water supply source. The samples were analyzed in duplicate in the laboratory of the Center for Research in Public Health - UNESP using an ion analyzer coupled to a fluoride-specific electrode.Results:A total of 19,533 samples were analyzed, of which 18,847 were artificially fluoridated and 686 were not artificially fluoridated. In samples from cities performing water fluoridation, 51.57% (n=9,720) had fluoride levels in the range of 0.55 to 0.84 mg F/L; 30.53% (n=5,754) were below 0.55 mg F/L and 17.90% (n=3,373) were above 0.84 mg F/L (maximum concentration=6.96 mg F/L). Most of the cities performing fluoridation that had a majority of samples with fluoride levels above the recommended parameter had deep wells and more than one source of water supply. There was some variability in the fluoride levels of samples from the same site and between collection sites in the same city.Conclusions:The majority of samples from cities performing fluoridation had fluoride levels within the range that provides the best combination of risks and benefits, minimizing the risk of dental fluorosis while preventing dental caries. The conduction of studies about water distribution systems is suggested in cities with high natural fluoride concentrations in order to optimize the use of natural fluoride for fluoridation costs and avoid the risk of dental fluorosis.

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External control of the public water supply in 29 Brazilian cities

Cited by 14 publications

References 21 publications

Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis

Fluoride concentrations in the water of Maringá, Brazil, considering the benefit/risk balance of caries and fluorosis

Dental fluorosis and its influence on children’s life

Water fluoridation in 40 Brazilian cities: 7 year analysis

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